Dr. Shadman on the Future of Venetoclax in CLL

Mazyar Shadman, MD, MPH, assistant member, Fred Hutchinson Cancer Research Center, discusses the future of venetoclax (Venclexta) in the treatment of chronic lymphocytic leukemia (CLL).

Venetoclax is a novel BCL-2 inhibitor that has demonstrated excellent efficacy in CLL, explains Shadman. When it comes to B-cell receptor inhibitors, physicians rarely see complete responses with minimal residual disease (MRD) negativity, notes Shadman. Though this may not be an issue for a patient who is receiving ongoing treatment, many patients express that they would like to discontinue treatment.

Treatment discontinuation is only possible if patients are able to achieve a deep response, explains Shadman. What is unique about venetoclax is the fact that it can provide very deep responses. Many patients tend to have a good response in terms of lymph node size reduction, and there are also those who demonstrate MRD in the bone marrow or in the blood. With longer follow up, venetoclax may allow more patients to discontinue treatment, notes Shadman.

Ongoing studies are combining venetoclax with the B-cell receptor inhibitors, namely ibrutinib (Imbruvica) and next-generation drugs, with the intention of eradicating disease in the bone marrow and inducing lymph node response. With the combination, physicians are hoping to induce a better and deeper response that may segue into more patients being able to discontinue treatment, concludes Shadman.